• Catriona Kennedy, Pauline O'Reilly, Gerard Fealy, Mary Casey, Anne-Marie Brady, Martin McNamara, Geraldine Prizeman, Daniela Rohde, and Josephine Hegarty.
• Department of Nursing and Midwifery, University of Limerick, Ireland.
• J Adv Nurs. 2015 Aug 1; 71 (8): 1797-811.

AimsTo review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks.BackgroundScope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society.DesignDiscussion paper.Data SourcesTwelve scope of practice and associated decision-making frameworks (January 2000-March 2014).Implications For NursingTwo main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice.ConclusionNursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction.© 2015 John Wiley & Sons Ltd.

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